Success in Practical Vocational

Nursing 8th Edition Knecht Test Bank

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Chapter 10: Cultural Uniqueness, Sensitivity, and Competence
Knecht: Success in Practical/Vocational Nursing: 8th Edition

MULTIPLE CHOICE

1. The nurse who states, “I believe in the uniqueness and value of human beings” is basing care
on the philosophy of
a. cultural competence.
b. individual worth.
c. assimilation.
d. cultural diversity.
ANS: B
Belief in the uniqueness and value of each human being, regardless of differences that may be
observed or perceived in that individual, is called the philosophy of individual worth. The
other options do not identify this belief. Cultural competence is the continuous attempt of
LPNs/LVNs to gain the knowledge and skills that will allow them to effectively provide care
for patients of different cultures. Assimilation is the process of a group giving up parts of their
own culture and adopting parts of the culture of the dominant group. Cultural diversity refers
to the many differences in the elements of culture in groups of people in American and
Canadian society.

DIF: Cognitive Level: Comprehension REF: p. 143 OBJ: 5

TOP: Philosophy of individual worth KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

2. A behavior to avoid when interacting with a person of a different culture is

a. diversity.
b. assimilation.
c. stereotyping.
d. behavior based on nonjudgmental attitudes.
ANS: C
Stereotyping, which is making inaccurate generalizations about all members of a specific
group without exception, is to be avoided. Stereotypes ignore individual differences. Diversity
refers to the many differences in the elements of culture in groups of people in American and
Canadian society. Assimilation is the process of a group giving up parts of their own culture
and adopting parts of the culture of the dominant group. A nonjudgmental attitude involves
being open-minded and taking difference at face value, accepting people as they are, and
giving high-quality care.

DIF: Cognitive Level: Analysis REF: p. 148 OBJ: 1

TOP: Stereotypes KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

3. A new mother on the OB unit refuses to allow her newborn to wear disposable diapers. She
insists on applying cloth diapers without safety pins, because this is how her culture applies
diapers. During break, the nurse discusses the patient’s strange diapering technique compared
with the excellent American method of diapering. Besides violating confidentiality, the nurse
is displaying
 a. ethnocentrism.
b. stereotyping.
c. unusual behavior during break.
d. lack of adherence to hospital policy on diapering.
ANS: A
Ethnocentrism is the belief that one’s way of doing things is better than the ways of people of
different cultures. Stereotyping is making false assumptions about others based on inaccurate
generalizations. Discussing the patient’s diapering technique during break is unethical. It is
unlikely that there is a policy on diapering.

DIF: Cognitive Level: Application REF: p. 137 OBJ: 1

TOP: Ethnocentrism KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

4. Which statement about culture will help the nurse implement culturally competent care?
a. Each culture measures other cultures using its own ways as the norm.
b. Culture is primarily based on genetic inheritance.
c. Stereotypes about cultures can be accepted as true.
d. Cultural diversity is based entirely on race.
ANS: A
The worth of everything, within or outside the group, depends on whether it fits the world
view of the cultural group. The other options are untrue statements. Culture is the total of all
the ideas, beliefs, values, attitudes, communication, customs, traditions, and objects a group of
people possess. A stereotype is an assumption used to describe all members of a specific
group without exception. It is an expectation that all individuals in a group will act exactly the
same in a situation just because they are members of that group. Cultural diversity refers to
the many differences in the elements of culture in groups of people in American and Canadian
society.

DIF: Cognitive Level: Analysis REF: p. 137 OBJ: 7

TOP: Culture KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

5. Patient A has terminal cancer, and Patient B has a bladder infection. They are sharing a
hospital room. Neither patient is a member of the majority culture of the area. Patient A is
quiet and rarely acknowledges pain. Patient B cries and moans loudly much of the day. What
understanding will help the nurse provide culturally sensitive care for both patients?
a. The better educated the person, the less likely the person is to openly express pain.
b. A mentally unstable person is more likely to be noisy about pain sensations.
c. People respond to the sensation of pain in culturally determined ways.
d. People who distrust health care workers tend to be silent about their pain.
ANS: C
One’s culture influences both the definition of pain and provides guidelines for approved
ways of expressing response to the sensation of pain. The other options are not true
statements.

DIF: Cognitive Level: Analysis REF: p. 145 OBJ: 6 | 7

TOP: Pain expression KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
6. Mrs. Lee tells the nurse who asks why she ate so little of the food on her tray that her
condition requires “hot” foods, so she ate only the “hot” foods on the tray. The nurse notices
that several items the patient left on the tray were served hot, and several of the foods the
patient ate were served cold. The nurse should
a. tell the dietary department to make sure Mrs. Lee’s foods are hot when served.
b. check Mrs. Lee’s menu choices and change choices from cold entrees to hot
entrees.
c. tell Mrs. Lee that no hospital food service serves entrees as hot as she may fix at
home.
d. ask Mrs. Lee to make a list of foods she believes would help her condition.
ANS: D
For this patient, “hot” and “cold” do not refer to the temperature at which food is served but
rather to culturally determined properties of the food. Asking for a list of foods Mrs. Lee
believes would help her condition is the most helpful action for the nurse to take. The other
options do not demonstrate understanding the culturally diverse meanings of “hot” and “cold.”

DIF: Cognitive Level: Application REF: p. 146 | p. 152 | p. 153

OBJ: 6|7 TOP: Health practices
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

7. A Native American patient keeps a small bunch of feathers on the over-the-bed table. They
are in the way whenever the nurse serves a tray or sets up equipment for a treatment. A
culturally competent action would be to
a. throw them away while the patient is sleeping.
b. move them to a place where they won’t be in the way.
c. leave them where the patient wishes to place them.
d. ask why there are a bunch of feathers in a hospital room.
ANS: C
Individuals of some cultures believe that amulets and charms are helpful in preventing or
curing illness. It is likely that the small bunch of feathers serves this purpose. Leaving them
where placed is the culturally sensitive thing to do. The nurse might also respectfully ask
about the feathers to gather data about the patient’s health beliefs and practices. The other
options are not culturally competent behaviors.

DIF: Cognitive Level: Application REF: p. 153 OBJ: 6 | 7

TOP: Culturally competent care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

8. A student nurse asks, “Does ethnocentrism have any negative consequences?” The most
accurate reply is based on the understanding that
a. discrimination is the basis for ethnocentrism and prejudice.
b. ethnocentrism may give rise to prejudice, which may result in discrimination.
c. prejudice has no relationship to ethnocentrism and discrimination.
d. ethnocentrism has only positive consequences associated with ethnic pride.
ANS: B
 When ethnocentrism, the belief that one’s culture is superior to other cultures, leads to
intolerance of another culture, prejudice results. Discrimination results when rights and
privileges are withheld from the other culture. The other options do not accurately explain the
relationship.

DIF: Cognitive Level: Comprehension REF: p. 137 OBJ: 1

TOP: Ethnocentrism KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A

9. During a discussion on cultural diversity, a nurse asks for an example of an ethnic group. The
most accurate response would be
a. Caucasians.
b. Spanish-speaking.
c. Irish-Americans.
d. homosexuals.
ANS: C
Ethnic groups are composed of people who are members of the same race, religion, or nation
and speak the same language. Irish-Americans are an example of an ethnic group. Caucasian
is a racial grouping. Spanish-speaking refers only to shared language, but the individuals
might be from Mexico, Spain, or the West Indies, each of which is ethnically different.
Homosexuals do not comprise an ethnic group.

DIF: Cognitive Level: Comprehension REF: p. 143 OBJ: 1 | 7

TOP: Ethnicity KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

10. Which statement by a nurse is an example of nonjudgmental thinking?

a. “Hispanic-American patients live at the poverty level and don’t have a chance.”
b. “Asian-American patients are unreadable. Nurses don’t know what they’re
feeling.”
c. “Native-American patients could benefit from a lesson in assimilation.”
d. “Cultural diversity accounts for some African Americans thinking illness is caused
by a curse.”
ANS: D
The correct statement makes no value judgments regarding whether this is good or bad. The
other options make judgments.

DIF: Cognitive Level: Application REF: p. 143 OBJ: 1 | 5 | 7

TOP: Nonjudgmental thinking KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

11. Which statement regarding cultural diversity can be used as a basis for caregiving?
a. Silence should always be interpreted as an indication of the patient’s
dissatisfaction with care.
b. Rules regarding the appropriate amount of eye contact vary among cultures.
c. Personal space requirements are similar for all cultures.
d. The germ theory of illness is universally accepted.
ANS: B
 The amount of eye contact that is desirable varies among cultures. The nurse should be aware
of cultural norms for eye contact for culturally diverse groups. The other options are not true
statements.

DIF: Cognitive Level: Analysis REF: p. 151 OBJ: 7

TOP: Eye contact KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

12. Which statement by a nurse demonstrates cultural competence?

a. “Without knowledge of cultural diversity, misunderstandings arise between patient
and nurse.”
b. “Nurses who assume care for persons of different cultures need to assume those
beliefs as their own in order to give good care.”
c. “Women of most cultures have adopted assertive communication.”
d. “Traditional healing practices should not be combined with Western medicine to
treat a patient.”
ANS: A
Failure to develop cultural sensitivity to patients of diverse cultural backgrounds may create
misunderstandings between nurse and patient. Data may be misinterpreted. Implementation of
plans and patient compliance with plans may be sabotaged if the nurse does not understand
the culture of the patient. The statement, “Nurses who assume care for persons of different
cultures need to assume those beliefs as their own in order to give good care” is unnecessary
and impractical. It is not true that women of most cultures have adopted assertive
communication. Traditional healing practices and Western medicine may be used in
combination with good results.

DIF: Cognitive Level: Application REF: p. 143 OBJ: 1 | 7

TOP: Cultural competence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

13. How would a culturally competent care plan differ from a standard care plan?
a. It would contain adaptations that recognize the patient’s cultural preferences.
b. It would follow the legal mandates for providing care regardless of culture.
c. It would provide information about nonjudgmental behaviors to use.
d. It would focus on the nurse’s values, assumptions, and health beliefs.
ANS: A
Culturally competent care involves continuous attempts by staff to use knowledge and skills
to effectively provide care for patients of different cultures. Adapting standard care to meet
the specific cultural preferences of the patient is part of a culturally competent care plan. The
other options would not be contained in a culturally competent plan of care.

DIF: Cognitive Level: Analysis REF: p. 152 | p. 153

OBJ: 1|7 TOP: Culturally competent care plan
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

14. Which of the following is an example of the process of socialization?

a. The student nurse assesses the needs of a patient who is a member of another
culture.
 b. The student nurse learns how to think and act like a nurse.
c. The student nurse uses cultural bias when evaluating the beliefs of a diverse
culture.
d. The student nurse demonstrates ethnocentrism related to health-illness beliefs.
ANS: B
Socialization is the process by which a person of one culture learns how to function within
another culture. The other options are not examples of the socialization process but rather are
merely statements that incorporate terms relating to culture.

DIF: Cognitive Level: Application REF: p. 137 OBJ: 6

TOP: Socialization KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

15. Which statement by a health care worker can the nurse identify as a stereotype?
a. “People over 65 are poor drivers.”
b. “Assimilation requires adopting part of the dominant culture.”
c. “All individuals have common basic daily needs.”
d. “Most people perceive themselves as members of the middle class.”
ANS: A
A stereotype is a false assumption about all members of a specific group. Saying people over
65 are poor drivers is an inaccurate generalization about a specific group of people. The other
options do not fit the definition of a stereotype.

DIF: Cognitive Level: Application REF: p. 137 OBJ: 1

TOP: Stereotyping KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

16. A patient tells the nurse that she is accustomed to adhering to a strict schedule for meals and
sleep. The nurse reports that the patient
a. follows clock time.
b. lives on linear time.
c. is obsessive-compulsive.
d. will complain if medications and treatments are not performed on time.
ANS: A
People who follow clock time eat, sleep, work, and engage in recreational activities at definite
times each day. People who live on linear time eat when they are hungry and sleep when tired,
without regard to the clock. The assessment that the patient is obsessive-compulsive cannot be
made with the provided information. The report that the patient will complain if medications
and treatments are not performed on time cannot be concluded from the information provided.

DIF: Cognitive Level: Application REF: p. 144 OBJ: 3

TOP: Concept of time
KEY: Nursing Process Step: Assessment (Data Collection)
MSC: NCLEX: Psychosocial Integrity

17. When collecting data, which question provides the best understanding of the patient’s
culturally determined food patterns and assists with developing a culturally competent care
plan?
a. “What effect will hospitalization have on your family?”
b. “What religious practices are important in your life?”
 c. “Do you use food to maintain health or treat illness?”
d. “Describe the role of children in your family.”
ANS: C
Although each of the questions is appropriate to ask in order to increase understanding of
cultural diversity, only one relates to food patterns.

DIF: Cognitive Level: Application REF: p. 151 OBJ: 1 | 7

TOP: Culturally competent care
KEY: Nursing Process Step: Assessment (Data Collection)
MSC: NCLEX: Psychosocial Integrity

18. Data collection suggests that a patient’s health beliefs are personalistic. Which statement by
the patient would the nurse determine as consistent with personalistic health beliefs?
a. “Please call my physician for me so I can discuss my symptoms.”
b. “I would like to wear the amulet that’s in my bedside stand.”
c. “X-rays will find the cause of my back pain.”
d. “I hope the doctor will recommend surgery.”
ANS: B
Personalistic health beliefs suggest that illness is caused by magical powers and is cured by
rituals. Wearing amulets offers protection from illness and may sometimes be considered
curative. The other statements are consistent with beliefs in biomedicine.

DIF: Cognitive Level: Analysis REF: p. 148 OBJ: 7

TOP: Personalistic health belief system
KEY: Nursing Process Step: Assessment (Data Collection)
MSC: NCLEX: Psychosocial Integrity

19. Recently a community has experienced an influx of individuals from Afghanistan. What
action should the nurse suggest to modify the agency environment to better accommodate
these culturally diverse patients?
a. Provide handouts and patient teaching materials in appropriate languages.
b. Hold meetings in the community to explain the Afghan culture.
c. Provide reference guides about Far Eastern cultures to all nursing staff.
d. Use the cookbook method of learning to accommodate this immigrant group.
ANS: A
Providing information in the language of the culturally diverse group indicates that the agency
is interested in serving individuals in the group. Ensuring understanding may also foster
compliance by the individual. The other options would not help to accommodate the
individuals from this group.

DIF: Cognitive Level: Application REF: pp. 150-152 OBJ: 7

TOP: Cultural competence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

20. The nurse sets a goal to avoid stereotyping culturally diverse patients. Which of the following
measures will help the nurse attain this goal?
a. Automatically apply all information known about a culture to patients of that
cultural group.
b. Assume that all individuals from Southeast Asia practice Buddhism.
 c. Refer to textbook information about cultural groups to predict individual behavior.
d. Gather information about how the patient believes illness can best be treated.
ANS: D
The treatments generally used by a patient will correspond to beliefs about illness causation
and may reveal the expectation to combine Eastern and Western treatments. Automatically
applying all information known about a culture to patients of that group, assuming that all
individuals from Southeast Asia practice Buddhism, and referring to textbook information to
predict individual behavior do not take into account the individual differences of patients from
the same cultural groups.

DIF: Cognitive Level: Comprehension REF: p. 152 OBJ: 7

TOP: Stereotyping KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

21. A nursing instructor is working with a Native-American student nurse. When the student is
late for the first clinical day, the instructor states, “I’m not surprised she’s late;
Native-American students are always late.” The instructor’s statement is an example of
a. prejudice.
b. stereotyping.
c. ethnocentrism.
d. discrimination.
ANS: B
Stereotyping is an assumption used to describe all members of a specific group without
exception. It is an expectation that all individuals in a group will act exactly the same in a
situation just because they are members of that group. Stereotyping ignores the individual
differences that occur within every cultural group.

DIF: Cognitive Level: Comprehension REF: p. 137 OBJ: 1

TOP: Stereotypes KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

22. A patient who uses the biomedical health belief system would be most likely to respond to
interventions by a
a. diviner.
b. shaman.
c. herbalist.
d. physician.
ANS: D
A physician cures disease based on the biomedical health belief system. The other options
refer to persons who cure disease based on the personalistic health belief system.

DIF: Cognitive Level: Comprehension REF: p. 148 OBJ: 7

TOP: Health belief systems KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

MULTIPLE RESPONSE

1. Which statements about emotions and their expression can provide a basis for providing care
to culturally diverse patients? (Select all that apply.)
 a. In some cultural groups, people do not display emotions openly in public.
b. Emotions are universal, but cues to those emotions vary.
c. Culture provides guidelines for approved ways of responding to pain.
d. Silence has various culturally determined meanings.
ANS: A, B, C, D
Each of the statements is correct and should be considered when planning care for patients of
the majority culture and for culturally diverse patients.

DIF: Cognitive Level: Analysis REF: p. 145 OBJ: 7

TOP: Cultural competence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

2. Mrs. X is a patient from South Korea. She has never experienced Western medical care. She is
hospitalized with hepatitis C. Which measures will lead to successful negotiation of a
treatment plan with this culturally diverse patient? (Select all that apply.)
a. Encourage the patient to explain her views about the cause of illness.
b. Explain the biomedical point of view of the health problem.
c. Support beliefs and practices the patient sees as helpful and that do no harm.
d. Realize that it is impossible to prevent a patient’s use of harmful health practices.
ANS: A, B, C
Encouraging the patient to explain her views about the cause of illness is necessary to
understand her health beliefs. Explaining the biomedical point of view of the health problem
allows the patient to compare her belief system with the biomedical explanation and to find
common ground. It also helps the patient understand the rationale for treatment. This is part of
the process of negotiating treatment plans with the patient. Many alternative healing practices
are known to be beneficial (acupuncture), and others may do no harm if used (diet based on
hot and cold principles). The nurse is participating in preserving helpful beliefs and practices.
The nurse can participate in repatterning by counseling against harmful practices and
supporting alternatives offered in the care plan.

DIF: Cognitive Level: Application REF: p. 152 | p. 153

OBJ: 7 TOP: Negotiating treatment plans
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

COMPLETION

1. The process of giving up parts of one’s own culture and adopting parts of the culture of the
dominant group is called ____________________.

ANS:
assimilation

The process of giving up parts of one’s own culture and adopting parts of the culture of the
dominant group is called assimilation.

DIF: Cognitive Level: Knowledge REF: p. 138 OBJ: 1

TOP: Assimilation KEY: Nursing Process Step: N/A MSC: NCLEX: N/A